An Outbreak of Adenovirus Type 7 in a Residential Facility for Severely Disabled Children
An Outbreak of Adenovirus Type 7 in a Residential Facility for Severely Disabled Children
复制标题
DOI：
10.1097/inf.0b013e31822702fe
复制
发表时间：
2011-11-01
影响因子：
3.6
通讯作者：
Engelhard, Dan
中科院分区：
文献类型：
--
作者：
Ghanaiem, Hammam;Averbuch, Diana;Engelhard, Dan
背景：腺病毒引起多种临床症状，涉及呼吸道、胃肠道、泌尿生殖系统和神经系统。目的：描述在一家养老院发生7型腺病毒感染期间，8名肢体和认知障碍儿童所患严重呼吸道疾病的特征和临床表现。方法：回顾分析住院期间因严重呼吸道症状住院的8名儿童的临床、影像和实验室结果。结果：在2010年2月的10天内，8名9个月至5岁(中位数22.5个月)的重度残疾儿童因严重急性呼吸道疾病合并低氧血症而住院。其中4例(50%)需要机械通气2~8天，1例出现多系统衰竭，包括急性肾功能衰竭。8例患儿呼吸道标本中均检出7型腺病毒。2例患者接受西多福韦静脉注射治疗。8例患者全部存活，住院6~15天(中位数：11.5天)后出院。流行病学调查显示，受影响的8名儿童在暴发前都与他们共用一个游戏室，并有一名护理员与他们一起工作，同时患有发热、喉咙痛和结膜炎。结论：7型腺病毒可能会在机构内引起短暂的感染暴发，导致儿童患上危及生命的疾病。提倡及早发现机构内引起呼吸道感染的病原体、隔离和其他预防性预防措施。此外，应考虑为机构中的卫生保健人员接种目前可获得的4型和7型腺病毒活疫苗和口服腺病毒疫苗。
Background: Adenoviruses cause a variety of clinical symptoms, involving the respiratory, gastrointestinal, urogenital, and neurologic systems. Only a few of the 55 known serotypes of adenovirus that affect humans can cause outbreaks of respiratory tract infection.Aim: To describe the characteristics and clinical manifestations of severe respiratory disease contracted by 8 physically and cognitively disabled children during a very short outbreak of adenovirus serotype 7 infection in a residential facility.Methods: The clinical, imaging, and laboratory findings of the patients who were hospitalized with severe respiratory symptoms were retrospectively reviewed. Molecular typing of the adenovirus was performed.Results: During 10 days in February 2010, 8 severely disabled children, 9 months to 5 years of age (median 22.5 months), from the same residential facility, were hospitalized due to severe acute respiratory disease with hypoxemia. Four of them (50%) needed mechanical ventilation for 2 to 8 days and one developed multisystem failure, including acute renal failure. Adenovirus serotype 7 was detected in the respiratory specimens of all 8 children. Two patients were treated with intravenous cidofovir. All 8 patients survived and were discharged after hospitalization of 6 to 15 (median: 11.5) days. The epidemiologic investigation revealed that all the 8 affected children shared a playroom and a caregiver worked with them while suffering fever, sore throat, and conjunctivitis before the onset of the outbreak.Conclusions: Adenovirus type 7 may cause short outbreaks of infection in institutions, causing children to develop life-threatening disease. Early detection of pathogens causing respiratory infections in institutions, isolation, and other preventive precautions are advocated. Moreover, vaccination of health care providers in institutions with the currently available live, oral adenovirus vaccine for types 4 and 7 should be considered.